目的 探讨晚期肺癌患者疾病感知和希望在依恋与应对方式之间的链式中介效应，为改善晚期肺癌患者应对方式提供理论依据。 方法 便利抽样法选取2021年10月至2022年6月安徽医科大学第一、二附属医院收治的354例晚期肺癌患者为研究对象。采用一般资料调查表、亲密关系经历量表、简易疾病感知问卷、Herth希望量表、医学应对问卷进行横断面调查。采用SPSS 25.0软件及Bootstrap法构建并验证链式中介模型。 结果 最终纳入336例晚期肺癌患者，其中男214例，女122例，年龄27~79（59.43 ± 8.61）岁。晚期肺癌患者依恋回避得分为（3.31 ± 1.01）分，依恋焦虑得分为（3.86 ± 1.17）分，疾病感知得分为（40.07 ± 12.01）分，希望得分为（34.05 ± 5.87）分，面对应对得分为（18.75 ± 5.34）分，回避应对得分为（15.47 ± 1.97）分，屈服应对得分为（9.62 ± 3.85）分。晚期肺癌患者依恋回避和依恋焦虑均与屈服应对呈正相关（r=0.448、0.747，均P<0.01），与疾病感知呈正相关（r=0.356、0.627，均P<0.01），与希望呈负相关（r=-0.406、-0.670，均P<0.01）；疾病感知与屈服应对呈正相关（r=0.744，P<0.01），与希望呈负相关（r=-0.628，P<0.01）；希望与屈服应对呈负相关（r=-0.769，P<0.01）。中介模型表明，晚期肺癌患者依恋回避→疾病感知→希望→屈服应对的链式中介作用显著，效应值为0.009，效应量为13.95%，依恋焦虑→疾病感知→希望→屈服应对的链式中介作用显著，效应值为0.010，效应量为8.27%。 结论 依恋既能直接预测晚期肺癌患者屈服应对，又可以通过疾病感知和希望的链式中介作用间接预测屈服应对。 Objective To explore the mediating chain effect between attachment and coping style of disease perception and hope in patients with advanced lung cancer, and to provide theoretical basis for improving coping style in patients with advanced lung cancer. Methods From October 2021 to June 2022, 354 patients with advanced lung cancer in the First and Second Affiliated Hospitals of Anhui Medical University were selected by convenience sampling. The general information questionnaire, the Experiences in Close Relationships Inventory, the Brief Illness Perception Questionnaire, the Herth Hope Index, and the Medical Coping Modes Questionnaire were used to conduct cross-sectional questionnaire survey. SPSS 25.0 software and Bootstrap method were used to construct and verify the chain mediation model. Results Finally, 336 patients with advanced lung cancer were included, including 214 males and 122 females, aged 27-79(59.43 ± 8.61) years old. Attachment avoidance score was (3.31 ± 1.01) points, attachment anxiety score was (3.86 ± 1.17) points, illness perception score was (40.07 ± 12.01) points, hope score was (34.05 ± 5.87) points, and face coping score was (18.75 ± 5.34) points in patients with advanced lung cancer. The avoidance coping score was (15.47 ± 1.97) points, and the yielding coping score was (9.62 ± 3.85) points. In patients with advanced lung cancer, attachment avoidance and attachment anxiety were positively correlated with yield coping (r=0.448, 0.747, both P<0.01), positively correlated with illness perception (r=0.356, 0.627, both P<0.01), and negatively correlated with hope (r=-0.406, -0.670, both P<0.01). Illness perception was positively correlated with yield coping (r=0.744, P<0.01), and negatively correlated with hope (r=-0.628, P<0.01). Hope was negatively correlated with yield response (r=-0.769, P<0.01). The mediation model showed that the chain mediating effect of attachment avoidance, illness perception, hope and yield coping was significant in patients with advanced lung cancer, with an effect value of 0.009 and an effect size of 13.95%. The chain mediating effect of attachment anxiety, illness perception, hope and yield coping were significant, with an effect value of 0.010 and an effect size of 8.27%. Conclusions Attachment can not only directly predict submission coping in advanced lung cancer patients, but also indirectly predict submission coping through the chain mediation of illness perception and hope.
Effect of attachment on coping styles in patients with advanced lung cancer: the chain-mediated role of disease perception and hope
Objective To explore the mediating chain effect between attachment and coping style of disease perception and hope in patients with advanced lung cancer, and to provide theoretical basis for improving coping style in patients with advanced lung cancer. Methods From October 2021 to June 2022, 354 patients with advanced lung cancer in the First and Second Affiliated Hospitals of Anhui Medical University were selected by convenience sampling. The general information questionnaire, the Experiences in Close Relationships Inventory, the Brief Illness Perception Questionnaire, the Herth Hope Index, and the Medical Coping Modes Questionnaire were used to conduct cross-sectional questionnaire survey. SPSS 25.0 software and Bootstrap method were used to construct and verify the chain mediation model. Results Finally, 336 patients with advanced lung cancer were included, including 214 males and 122 females, aged 27-79(59.43 ± 8.61) years old. Attachment avoidance score was (3.31 ± 1.01) points, attachment anxiety score was (3.86 ± 1.17) points, illness perception score was (40.07 ± 12.01) points, hope score was (34.05 ± 5.87) points, and face coping score was (18.75 ± 5.34) points in patients with advanced lung cancer. The avoidance coping score was (15.47 ± 1.97) points, and the yielding coping score was (9.62 ± 3.85) points. In patients with advanced lung cancer, attachment avoidance and attachment anxiety were positively correlated with yield coping (r=0.448, 0.747, both P<0.01), positively correlated with illness perception (r=0.356, 0.627, both P<0.01), and negatively correlated with hope (r=-0.406, -0.670, both P<0.01). Illness perception was positively correlated with yield coping (r=0.744, P<0.01), and negatively correlated with hope (r=-0.628, P<0.01). Hope was negatively correlated with yield response (r=-0.769, P<0.01). The mediation model showed that the chain mediating effect of attachment avoidance, illness perception, hope and yield coping was significant in patients with advanced lung cancer, with an effect value of 0.009 and an effect size of 13.95%. The chain mediating effect of attachment anxiety, illness perception, hope and yield coping were significant, with an effect value of 0.010 and an effect size of 8.27%. Conclusions Attachment can not only directly predict submission coping in advanced lung cancer patients, but also indirectly predict submission coping through the chain mediation of illness perception and hope.
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